Abstract
Objective: To identify predictors of fatal outcome of severe malaria in children admitted to a tertiary care centre. Method: This retrospective study was performed at a tertiary health care institution which is a low transmission area of malaria. Confirmed malaria patients (P. falciparum, P. vivax or mixed infection) satisfying one or more of the 2010 WHO criteria for severe malaria were included in the study. Prevalence of fatal outcome due to major symptoms was calculated followed by univariate regression analysis to identify major predictors of fatal outcome. Results: A total of 102 children satisfied WHO criteria of severe malaria and were included in the study. Fatal outcome was seen in 14 children and girls (71.4%; 10/14) were more affected as compared to boys (p 7years) but this was not a predicting factor for fatal outcome (p>0.05). Fatal outcome was seen more in children with falciparum infestation (78.5%; 11/14) but this was insignificant (p>0.05). Univariate regression analysis identified impaired consciousness (p Conclusions: Impaired consciousness, shock, spontaneous bleeding, multisystem involvement, gastrointestinal dysfunction, renal failure and respiratory distress were predictors of fatal outcome of severe malaria in children admitted to the tertiary care centre. Sri Lanka Journal of Child Health , 2015; 44 (1): 17-23 DOI: http://dx.doi.org/10.4038/sljch.v44i1.7958
Highlights
2.48 million malaria cases are reported annually from South Asia of which 65% are from India[1]
Impaired consciousness, shock, spontaneous bleeding, multisystem involvement, gastrointestinal dysfunction, renal failure and respiratory distress were predictors of fatal outcome of severe malaria in children admitted to the tertiary care centre
World Health Organization (WHO) has described criteria for severe malaria only in plasmodium falciparum (P. falciparum) patients but it is proven that plasmodium vivax (P. vivax) and mixed infection (P. vivax and P. falciparum detected in the same child) can culminate into severe malaria[6]
Summary
2.48 million malaria cases are reported annually from South Asia of which 65% are from India[1]. WHO has described criteria for severe malaria only in plasmodium falciparum (P. falciparum) patients but it is proven that plasmodium vivax (P. vivax) and mixed infection (P. vivax and P. falciparum detected in the same child) can culminate into severe malaria[6]. This retrospective study was undertaken in the Bhopal district of Central India which has reported 7.0% of all malaria cases and 14.4% of malaria deaths in 2011 in the country[7]. Substantial research on predictors of mortality of severe malaria has been done in high transmission areas of Africa with few from unstable or low transmission areas of world[8,9,10]
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